PURPOSE: To examine the relationship among hypermetropia, axial length, and hypertension in a Chinese population. DESIGN: Population-based cross-sectional study. METHODS: This study included 1213 Chinese individuals aged 40 to 81 years. Hypertension was defined as systolic blood pressure > or =140 mm Hg, diastolic blood pressure > or =90 mm Hg, or self-report history of antihypertension treatment. Refraction was determined with an autorefractor and refined subjectively. A-mode ultrasound scanning was used to measure axial length. RESULTS: The crude odds ratio of hypertension was 2.5 (95% CI, 1.4-4.6) for moderate hypermetropia (> or =+2.00 spheric equivalent diopters) vs high myopia (< or =-6.00 diopters), and 1.4 (95% CI, 0.9-2.1) for highest vs lowest axial length quintile. These associations were no longer significant after adjustment for age, gender, education, housing type, and income. CONCLUSIONS: These data provide no evidence that hypermetropia or shorter axial length is associated independently with hypertension in Chinese individuals.